Walking a Fine Line

For the last two months or so, Little Brother has benefited from some wonderful technology that helps with his diabetes care.

dexcom g4

This continuous glucose monitor checks his blood sugar every 5 minutes, allowing us to get ahead of highs or lows–and those lows are happening with greater frequency now that the weather is fine and he’s spending hours on end in the pool. In addition, the routines and schedules around schoolday mealtimes are not in place in the summer, so we can use all the help we can get.

But I got a phone call yesterday from the manufacturer of this device, informing me that our insurance won’t cover it because the diabetes medical provider used a certain diagnosis code. If a different code were used, this would be a no-brainer. Our provider used a code that means “diabetes with no complications.” If they had used the code that means “diabetes, uncontrolled” we could have the CGM.

So basically we’re too good at caring for our child to qualify for the technology that helps us care for our child.

Little Brother has a picture-perfect A1C (an average blood sugar over 3 months). For 2 of those last 3 months we have had the CGM to help us keep him there. But in the last few weeks, his sugar has been on a roller coaster, what with swimming and backyard soccer and sleeping late and eating at friends’ homes where Guess The Carbs is a spectator sport. In the past 2 weeks he’s had several scary lows, including last night when he “pinned” that meter at 40 for more than 10 minutes (a blood test, at one point, showed his glucose level at 37).

If that’s not “uncontrolled,” I don’t know what is.

We need all the help we can get, and his provider and the insurance company are making it really difficult for us to do that without incurring crazy out-of-pocket expenses.